skip to main content

Pulsed Field Ablation — EECC MCQ

Instant feedback + full explanation. One question, done properly.

ModerateArrhythmia & ElectrophysiologyPulsed Field AblationEECC

A 55-year-old man with persistent AF and a structurally normal heart undergoes catheter ablation. The operator uses pulsed field ablation (PFA) instead of traditional radiofrequency (RF) ablation. What is the key advantage of PFA?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — PFA selectively targets cardiac myocytes via irreversible electroporation with minimal damage to adjacent structures (oesophagus, phrenic nerve, coronary arteries), reducing the risk of collateral injury

Pulsed field ablation (PFA) represents a paradigm shift in catheter ablation technology. It delivers high-voltage ultrashort electrical pulses that cause irreversible electroporation (permanent cell membrane disruption) of cardiac myocytes, which are preferentially susceptible to this energy form. Crucially, non-cardiac tissues (oesophagus, phrenic nerve, coronary arteries) have higher electroporation thresholds and are relatively spared — dramatically reducing the risk of collateral injuries (oesophageal fistula, phrenic nerve palsy). The ADVENT trial demonstrated non-inferiority of PFA to thermal ablation (RF/cryo) for PVI with a superior safety profile. PFA has been rapidly adopted and is expected to become the dominant ablation modality for AF.

Reference: ESC (2024): AF Guidelines; ADVENT Trial